When Alvin arrived at the hospital, he believed he’d been sent there as a doctor working on behalf of the U.S. government. “Which patient do I need to see first?” he asked the triage nurse.
Until recently, Alvin had been an ordinary economics graduate student. But somehow he’d become convinced that he was a trailblazing physician who needed to identify a rare strain of tuberculosis before it spread throughout campus.
That morning, he arrived at his graduate school classroom with a stethoscope around his neck, a surgical mask over his face and a bag containing more masks and several thermometers. He began to practice medicine on his classmates.
At first, his manner and physician attire made them think he was joking, as Halloween was just around the corner. But when he tried to remove the shirt of a female student to better listen to her lungs, their late-arriving professor called the police. And the police called an ambulance.
What caused this previously healthy 25-year-old man to become delusional? After an initial screening from the emergency medicine physician on duty, I was called to sort this out.
